改良黏小管切开术治疗继发性青光眼的临床研究  

The clinical research of modified viscocanalostomy for the management of secondary glaucoma

作　　者：李春慧 梁亚[2,3] 殷雪[2,3] 袁志兰[2,3] 

机构地区：[1]南京医科大学,210029 [2]南京医科大学第一附属医院眼科 [3]江苏省人民医院,210029

出　　处：《临床眼科杂志》2013年第4期325-328,共4页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(81271001)

摘　　要：目的观察改良黏小管切开术治疗不同类型继发性青光眼的有效性及安全性。并探讨黏小管切开术的适应证。方法临床病例系列研究。对2008年7月至2012年12月接受改良黏小管切开术的继发性青光眼18例(20只眼)患者进行回顾性分析。比较术前及术后的视力、视野、眼压、杯盘比,并记录继发性青光眼的病因、滤过泡形态、是否行激光房角穿孔术及有无并发症发生。对术前及术后1、3 d,1、3、6个月,1、2年的眼压进行比较,采用成组t检验的方法进行统计学分析。结果患者均有轻度到中度隆起的弥散滤过泡,术前眼压为(38.815±2.387)mm Hg,术后各随访时间点的眼压分别为(8.305±0.562)mm Hg、(9.490±0.846)mm Hg、(12.775±2.029)mm Hg、(13.184±1.143)mm Hg、(13.694±1.162)mm Hg、(14.108±1.432)mm Hg、(13.563±1.090)mmHg、(13.710±0.921)mm Hg。术前及术后各时间点眼压的差异有统计学意义(P<0.05)。3例(3只眼,15%)患者因术后眼压升高≥21 mm Hg,行激光房角穿孔术。少数患者存在视力、视野及眼底杯盘比的变化。结论改良黏小管切开术能够有效并安全的降低继发性青光眼的眼压,对炎症相关继发性青光眼的治疗效果好。Objective To evaluate the effectiveness and safety of modified viscocanalostomy for the management of different types of secondary glaucoma and discuss the indications of advanced viscocanalostomy.Methods This was a clinical case series study.18 patients（20 eyes） with secondary glaucoma were included in a retrospective analysis,who were operated from July of 2008 to December of 2012.These were compared,which were visual acuity,visual field,intraocular pressure（IOP） and cup by disc ratio（c / d） before and after the surgery.Moreover,the causes of secondary glaucoma,filtering bulb,laser goniopuncture（LGP） and complications were also studied.T test was applied to analyze the difference before and 1 day,3 days,1 month,3 months,half a year,1 year,2 years after the surgery.The differences were significant.Results All of the patients had diffuse filtering bulb.The IOP before and after the surgery were（38.815 ± 2.387） mm Hg,（8.305 ± 0.562） mm Hg,（9.490 ± 0.846） mm Hg,（12.775 ± 2.029） mm Hg,（13.184 ± 1.143） mm Hg,（13.694 ±1.162） mm Hg,（14.108 ±1.432） mm Hg,（13.563 ±1.090） mm Hg,（13.710 ±0.921） mm Hg.The differences before and after the surgery were significant（P 0.05）.3 patients（3 eyes,15%） experienced LGP,because the IOP increased over 21 mm Hg.Few patients had deteriorating visual acuity,visual field and c/d.Conclusion Modiefied viscocanalostomy could reduced the IOP of patients with secondary glaucoma in a effective and safe way.It was especially effective in the secondary glaucoma relative to inflammation.

关 键 词：改良黏小管切开术 继发性青光眼 视力 眼压 适应证 

分 类 号：R779.6[医药卫生—眼科]